title: Concentric craniotomy: removal of tumor involving the skull and the intracranial space.
abstract: BACKGROUND
  Removal of a tumor involving both the intracranial space and the skull presents technical challenges. This is especially so if there is a potential for significant hemorrhage due to a hemangioma or a significant attachment to the brain as with a meningioma.
  
  
  METHODS
  We describe a technique where the tumor attached to the skull is left undisturbed and a second wider concentric craniotomy exposes normal dura. The entire tumor, both intracranial and that involving the skull and dura, can then be removed as one specimen.
  
  
  CONCLUSIONS
  The technique we describe, a concentric craniotomy, transforms a difficult operation with the potential for significant hemorrhage into a more standard removal of a convexity tumor.
authors.affiliation: Section of Neurosurgery, Department of Surgery, Addis Ababa University, Addis Ababa, Ethiopia.
authors.forename: Berhanu H
authors.initials: BH
authors.lastname: Michael
authors.affiliation: Section of Neurosurgery, Department of Surgery, Addis Ababa University, Addis Ababa, Ethiopia.
authors.forename: Tadese
authors.initials: T
authors.lastname: Kebede
authors.affiliation: Section of Neurosurgery, Department of Surgery, Addis Ababa University, Addis Ababa, Ethiopia.
authors.forename: Hagos
authors.initials: H
authors.lastname: Biluts
authors.affiliation: Department of Radiology, Addis Ababa University, Addis Ababa, Ethiopia.
authors.forename: Getachew
authors.initials: G
authors.lastname: Affefa
authors.affiliation: Department of Pathology, Addis Ababa University, Addis Ababa, Ethiopia.
authors.forename: Jacob
authors.initials: J
authors.lastname: Schneider
authors.affiliation: Department of Neurosurgery, Lahey Clinic, Burlington, Massachusetts, USA. Electronic address: stephen.r.freidberg@lahey.org.
authors.forename: Stephen R
authors.initials: SR
authors.lastname: Freidberg
mesh_terms: D000328:Adult; D003399:Craniotomy / Q000379:methods*; D004388:Dura Mater / Q000000981:diagnostic imaging / Q000601:surgery; D006391:Hemangioma / Q000000981:diagnostic imaging / Q000601:surgery*; D006801:Humans; D008297:Male; D008577:Meningeal Neoplasms / Q000000981:diagnostic imaging / Q000601:surgery*; D008579:Meningioma / Q000000981:diagnostic imaging / Q000601:surgery*; D012888:Skull Neoplasms / Q000000981:diagnostic imaging / Q000601:surgery*; D014057:Tomography, X-Ray Computed
keywords: Concentric craniotomy; Hemangioma skull; Meningioma; Tumor skull and dura